Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, University of Barcelona, Terrassa, Catalonia, 08221, Spain.
World J Gastroenterol. 2011 Jun 14;17(22):2708-14. doi: 10.3748/wjg.v17.i22.2708.
The majority of patients with inflammatory bowel disease (IBD) achieve good control of the inflammatory activity using available therapies. When remission is achieved and quality of life recovered, a considerable proportion of IBD patients express their desire to travel abroad, be it for business, academic or leisure purposes. Their physicians should help and encourage them whenever possible. However, preventive measures are warranted to minimize the risk, since IBD patients are exposed to the same infections affecting the general population, plus opportunistic infections (OI) related to the immunosuppression. There are a large number of potential OI that might affect patients with IBD. The true prevalence of these infections is unknown, and can vary from country to country. Therefore, reactivation or de novo acquisition of infections such as tuberculosis, malaria, and viral hepatitis will be much more frequent in endemic areas. Therefore, physicians should be aware of these aspects when planning specific preventive measures for patients traveling to a particular country. This includes good control of environmental exposure, chemoprophylaxis when indicated, and the use of a specific vaccination program to prevent endemic infections. In addition, it should be noted that, though the risk of acquiring an infectious disease is probably greater for IBD patients traveling from a developed to a developing country, the inverse situation can also occur; it depends on the previous acquired immunity of the host against infections in any particular environment.
大多数炎症性肠病（IBD）患者使用现有疗法可实现炎症活动的良好控制。当达到缓解且生活质量恢复后，相当一部分 IBD 患者表示希望出国旅行，无论是出于商务、学术还是休闲目的。医生应尽可能为他们提供帮助和鼓励。然而，需要采取预防措施来尽量降低风险，因为 IBD 患者面临与普通人群相同的感染风险，以及与免疫抑制相关的机会性感染（OI）。有大量潜在的 OI 可能影响 IBD 患者。这些感染的真实患病率尚不清楚，并且可能因国家而异。因此，在流行地区，结核病、疟疾和病毒性肝炎等感染的再激活或新发病例会更加频繁。因此，当为前往特定国家旅行的患者制定特定的预防措施时，医生应注意这些方面。这包括良好控制环境暴露、在有指征时进行化学预防以及使用特定的疫苗接种计划来预防地方性感染。此外，应该注意的是，尽管从发达国家前往发展中国家的 IBD 患者获得传染病的风险可能更高，但情况也可能相反；这取决于宿主在任何特定环境中针对感染获得的先前免疫力。
